某三级甲等医院肺炎克雷伯菌耐药性及耐药基因分析

目的:分析某三级甲等医院连续4年肺炎克雷伯菌的耐药性及耐药基因分布,了解耐药性变化趋势,指导临床合理用药。方法:使用VITEK-32全自动微生物分析仪进行细菌鉴定,用纸片法和最低抑菌浓度(MIC)试验进行药敏分析,用聚合酶链式反应(PCR)对产超广谱β-内酰胺酶(ESBLs)菌株可能携带的主要β-内酰胺酶耐药基因进行检测。结果:在182株临床分离的肺炎克雷伯菌中,痰和咽拭子标本分离率占首位(78.6%);对检测的13种抗菌药物耐药谱分析显示,该菌对哌拉西林耐药率最高,对亚胺培南和美罗培南敏感;产ESBLs菌株的检出率约30%;51%以上的产ESBLs菌株携带至少1种所检测的耐药基因,以blaTEM为主。结论:该院肺炎克雷伯菌分离株耐药范围广、产ESBLs菌检出率高,应引起重视。

Analysis of Antibiotics Resistance of Klebsiella Pneumoniae and Drug Resistance Gene from a Class Three Grade A Hospital

OBJECTIVE:To analyze the antibiotic resistance of Klebsiella pneumoniae and distribution of drug resistance gene from a class three grade A hospital in order to investigate the trend of drug resistance change and guide the rational use of antibiotics in the clinic.METHODS:The identification of K.pneumoniae isolates from clinical samples was performed by the VITEK-32 system.The susceptibility test to antimicrobial agents was determined by Disk Diffusion and MIC testing.Detection of β-lactamases gene in the ESBLs-producing isolates was performed using PCR.RESULTS:The highest detection rate of K.pneumoniae was found from sputum and throat swab(78.6%).As to K.pneumoniae,the resistance ratio to piperacillin was the highest,while imipenem and meropenem was sensitive to bacterial.The detection rate of ESBLs-producing strains was almost 30%.More than 51% of ESBLs-producing strains carried at least a kind of detected β-lactamases genes.Among them,blaTEM gene was the main prevalence gene.CONCLUSION:K.pneumoniae isolates show extensive drug resistance in the hospital with high detection rate of ESBLs-producing strains,which should get more attention in the clinic.